TMF is the Quality Improvement Organization for people with Medicare in Texas. We strive to improve your health and quality of life.
July 31, 2010
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Breast Cancer Screenings and Mammography

According to the American Cancer Society, breast cancer strikes nearly 200,000 U.S. women a year and kills 40,000 of them. Research has shown that when breast cancer is detected in its earliest stages, there is a 97 percent survival rate. A mammogram is the most reliable way to detect breast cancer.

Find more resources about this and other preventive services on the Helpful Publications page.

Medicare Coverage for Mammograms: Questions and Answers
Q: How often is it covered?

A: Once every 12 months

Q: For whom?

A: All women with Medicare age 40 and older can get a screening mammogram every 12 months. Medicare also pays for one baseline mammogram for women with Medicare between ages 35 and 39.

Q: Your costs in the Original Medicare Plan?

A: You pay 20% of the Medicare-approved amount with no Part B deductible.

Breast Cancer and Mammogram Frequently Asked Questions

Printable versions: English brochure (1.59MB PDF) / Español (1.59MB PDF)

Q: What is breast cancer?

A: Breast cancer is a cancerous tumor that starts in the breast. It is the second most common cancer among women. Over 97 percent of breast cancers can be treated successfully if they are found early. The best way to find breast cancer early is with a mammogram.

Q: What is a mammogram?

A: A mammogram is a picture of the breast. Mammograms are 85 to 90 percent successful in finding breast cancers up to two years before you or your doctor can feel a lump.

Q: Who should have a mammogram?

A: All women age 40 and older should have a mammogram every year. Your chance of getting breast cancer increases as you age. Over 75 percent of new breast cancer cases occur in women age 50 and older.

Q: No one in my family had breast cancer. Do I still need a mammogram?

A: Yes! The majority of women who get breast cancer have no family history of the disease.

Q: I don’t feel any pain or lumps in my breasts. Should I still get a mammogram?

A: Yes! You may not feel any pain or lumps if you have breast cancer. Breast cancer may not have any symptoms. That’s why it’s important for you to get your mammogram every year, perform monthly self breast exams and have regular clinical breast exams done by your doctor.

Q: How is a mammogram done?

A: During a mammogram, your breasts are gently pressed flat between two x-ray panels. You will feel pressure on your breasts for a few seconds while a picture is taken from the top and from the side. The entire procedure only takes a few minutes.

Q: Does a mammogram hurt?

A: Not usually. Some women may experience discomfort for a few seconds while the x-ray is taken. For most women, this discomfort is mild and worthwhile because they want to be there for their family. Most women do not experience pain. If you do experience pain during the mammogram, tell the technician.

Q: Will radiation from a mammogram hurt me?

A: No. Mammograms are safe. There is very little radiation exposure. The amount of radiation is similar to what you would get on a long plane flight.

Q: Will Medicare cover a yearly mammogram?

A: Medicare will cover 80 percent of the Medicare-approved amount, and you will be responsible for a copayment of 20 percent. Make sure that the mammography facility accepts Medicare assignment. This means that they will take the Medicare-approved amount and your copayment as payment in full and will not charge you additional fees. Your copayment should not be more than $30.

Find a Mammography Facility

You may be more comfortable getting a mammogram at a facility located close to your home. To find a convenient facility, go to this page on the U.S. Food and Drug Administration website.

Other Mammography and Breast Cancer Resources

Contact the following community organizations for information about breast cancer, educational materials, information about where to get a mammogram, information on low-cost mammograms and local events and activities.

TMF has received Independent Review Organization accreditation from URAC. TMF has received Health Utilization Management accreditation from URAC. TMF is a GSA Contract Holder.